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Light stools are a change that does not always indicate a disease, especially if there are no other symptoms. However, when this change is associated with other symptoms, it can indicate more serious he alth problems. The most appropriate medical terms to refer to this change are “faecal hypocholy”: when the stools only become lighter; or “fecal acholia”: when stools are whitish.
Normally, stools are brown in color, as a result of a mixture between bile, substances produced in the intestine and products of digestion. In this way, factors that lead to a decrease or absence of bile in the intestine can cause the stool to lose color, resulting in pale or very pale stools.
Light or whitish stools, especially when associated with symptoms such as abdominal pain, yellowing of the skin and eyes (jaundice) or darkening of the urine, should be evaluated by a general practitioner or gastroenterologist.
Choledocolithiasis is an obstruction of the bile ducts by a stone (calculus) that may have formed inside it or inside the gallbladder itself. In addition to lighter stools, other symptoms include yellowing of the skin and eyes (jaundice), generalized itching, abdominal pain, nausea, vomiting, and darkening of the urine.
What to do: It is important to consult a general practitioner or gastroenterologist, as tests are required to confirm the diagnosis of choledocholithiasis. Treatment is usually done through surgery, with the aim of removing the stone and preventing the disease from getting complicated.
2. Use of medication
Drug hepatitis is caused by the use of drugs, which can impair the functioning of the liver and thus affect the process of producing bile, contributing to the change in the color of stools. The main medications that can cause pale stools are antibiotics, although this is an uncommon side effect. In addition, dietary supplements, herbal medicines, anticonvulsants, antihypertensives, analgesics and other medications can also cause this type of change.
Drug hepatitis is not always easy to identify through its symptoms, but some people may experience dark urine, nausea, vomiting, abdominal pain, jaundice, and stool discoloration, which may appear between 5 days and 3 months later. the start of the drug. See more causes, symptoms and treatment of drug hepatitis.
What to do: It is important that a doctor, preferably the one who prescribed the medication, be consulted, since other causes must be ruled out before discontinuing the use of the medication.When confirmed, the treatment involves suspending the use of the drug.
3. Viral hepatitis
Viral hepatitis, such as hepatitis A, B, C, D, or E, are relatively common infectious diseases that can cause pale stools, yellowing of the skin and eyes (jaundice), and dark urine.
In addition to these, other symptoms such as fatigue, nausea, loss of appetite, fever, abdominal pain, diarrhea, joint pain and redness of the skin may also arise. Check out the main symptoms of hepatitis.
What to do: It is recommended to consult a general practitioner or gastroenterologist to confirm the diagnosis and initiate appropriate treatment. Treatment varies according to the type of viral hepatitis and can range from simple measures such as maintaining hydration and using common antipyretic medications and analgesics, to more specific measures such as the use of antivirals.
4. Complication of surgeries
Some surgeries involving the bile ducts, such as removing the gallbladder, for example, can cause obstructions in the flow of bile. When this happens, pale stools may appear, as well as other symptoms such as yellow skin and eyes (jaundice) and intense itching.
What to do: Ideally, you should consult the surgeon responsible for the surgery, in order to confirm the diagnosis and start treatment as soon as possible. Treatment may include further surgery to correct the bile ducts.
5. Tumors in the bile ducts
Although it is more rare, the appearance of tumors in the bile ducts, gallbladder or other nearby sites can also cause a change in stool color.
Often, tumors do not cause any symptoms initially, but over time they can cause, in addition to whitish stools, other symptoms such as abdominal pain, yellow skin and eyes (jaundice), itching, weight loss and malaise. be.
What to do: if tumors are suspected, it is important to consult a general practitioner or gastroenterologist for a detailed evaluation and order tests to help rule out or confirm the diagnosis. Treatment will depend on the type of tumor identified, but usually includes surgical removal.
6. Biliary atresia
Biliary atresia is an important cause of whitish or very pale stools in babies, especially newborns. What happens is the progressive closure of a part of these pathways due to inflammation and fibrosis. Thus, affected newborns usually have symptoms that begin between 2 and 5 weeks of age and include whitish stools (fecal acholia) and prolonged jaundice.
What to do: It is recommended that a pediatrician be consulted as soon as possible, because the sooner the diagnosis and the correction that allows to restore the normal flow of bile (usually before 2 months of age), the better the results and the lower the chance of complications.
7. Choledochal cyst
The choledochal cyst is another important cause of pale stools in babies and corresponds to a dilatation, present from birth, of the bile transport pathways. Most affected children have symptoms related to difficulty draining bile. These symptoms usually involve jaundice, whitish stools, and abdominal distention.
What to do: It is recommended that a pediatrician or pediatric gastroenterologist be consulted, as the diagnosis of choledochal cyst requires imaging tests, such as ultrasound abdominal. Its treatment, however, is through surgery, by removing the cysts.
Exams that help in diagnosis
Exams that help confirm or rule out the possible cause of light stools vary according to the suspicion, but initially may include:
- Blood test to measure liver enzymes, alkaline phosphatase, gamma glutamyl transferase and bilirubins;
- Blood tests to detect antigens and antibodies against hepatitis-causing viruses;
- Ultrasonography of the liver and bile ducts.
In addition to these, the doctor may order other more accurate tests, such as computed tomography, endoscopic retrograde cholangiopancreatography or magnetic resonance cholangiopancreatography. Some cases may still require a liver biopsy or other tests in order to clarify the diagnosis. Check out other tests used to evaluate the bile ducts.